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Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The axillary vein is located within the axillary sheath, a connective tissue sleeve that also surrounds the axillary artery and the brachial plexus. The axillary artery (Figure 4.4) is the continuation of the subclavian artery; it begins at the lateral border of the first rib, and ends at the inferior border of the teres major where its name changes to brachial artery (”artery of the arm”). The easiest way to learn the branches of the axillary artery is to divide it into three parts: The first, second, and third parts lie medially, posteriorly, and laterally to the pectoralis minor muscle, respectively (Plate 4.9). Details about the specific muscles that the branches of the axillary artery supply are given in Tables 4.1 and 4.2. The first part of the axillary artery has one branch: the superior thoracic artery, which makes sense because this is the most medial—and thus superior—branch of the axillary artery and lies in the thoracic region, supplying mainly the first and second intercostal spaces.
Angiographie Anatomy of the Peripheral Vasculature and the Non-invasive Assessment of Peripheral Vascular Disease
Published in Richard R Heuser, Giancarlo Biamino, Peripheral Vascular Stenting, 1999
Philip A. Morales, Richard R. Heuser
After the vertebral artery, the subclavian artery gives rise to four major branches: internal mammary, thyrocervical trunk, dorsal scapular artery, and suprascapular artery (Fig. 2.4). Next, the subclavian artery heads inferiorly and crosses the first rib. At this landmark, it becomes the axillary artery and gives rise to the following branches: superior thoracic artery, thoracoacromial artery, lateral thoracic artery, subscapular artery, and the circumflex humeral branches (Fig. 2.5). Next the axillary artery crosses the lower border of the tendon of the teres major where it becomes the brachial artery. The main branches of the brachial artery are the profunda brachial and the superior ulnar collateral arteries, both of which form a collateralization network around the brachial artery. The brachial artery bifurcates into the ulnar and radial arteries below the elbow.
A bullet through the aortic arch
Published in Acta Cardiologica, 2018
Thomas Nguyen, Martine Antoine, Frédéric Vanden Eynden, Guido Van Nooten, Bachar El Oumeiri
A 45-year-old male was admitted in shock at the emergency department with a gunshot wound to the chest. The entry wound was located in the middle of the sternum at the level of the 3rd intercostal space. Surprisingly, emergency echocardiography detected no pericardial effusion. The aortic CT-angiography revealed two separate perforations of the aortic arch: one at the base of the brachio-cephalic trunk (Panels A, B, C, D, arrow), another at the origin of the left subclavian artery (Panels A, B, C, D, arrowhead) and a rupture of the superior thoracic artery and a pulmonary contusion of the right upper lobe. The bullet fragments were found lodged in the body of the 4th thoracic vertebra after having perforated the oesophagus (Panel C, curved arrow). The patient was rushed to the operating room and the aortic arch was successfully repaired under deep hypothermia and circulatory arrest without major blood loss. A stent was placed in the oesophagus. The patient recovered completely and was discharged after 10 days.
Pacemaker site pseudoaneurysm from superior thoracic artery: an uncommon offender
Published in Acta Cardiologica, 2019
Arun Sharma, Niraj Nirmal Pandey, Sanjeev Kumar
A pseudoaneurysm is a rare complication after pacemaker placement procedures. Its occurrence has previously been reported in a few case reports only where they described these rare entities arising from an axillary artery or the internal mammary artery. However, pseudoaneurysm from the superior thoracic artery has not been described so far. Because of the risk of expansion and rupture, prompt repair is indicated in these cases. Endovascular management is preferred in these lesions as surgery may entail the risk of injury to neurovascular bundle. Endovascular treatment options may include ultrasound-guided thrombin injection, embolisation or stent graft placement.